Journal of Bashir Institute of Health Sciences

A Study on the Frequency and Types of Laboratory Errors in a Tertiary Care Cardiology Laboratory

Ahsan Riaz — 2025-12-19

Background

Particularly in critical care settings like cardiology, where precise and prompt results are crucial, laboratory errors can have a substantial impact on patient diagnosis, treatment choices, and general safety.

Objective

The objective of the study was to thoroughly analyse error occurrence rates throughout the entire process of testing, with regard to the pre-analytical, analytical, and post-analytical stages.

Methods

Over the course of three months, from July to September 2019, a prospective analysis of laboratory errors was conducted at the Rawalpindi Institute of Cardiology (RIC), a 272-bed tertiary care facility serving the Punjab province and parts of Azad Jammu and Kashmir (AJK) and Khyber Pakhtunkhwa (KPK). During this time, the clinical pathology laboratory at the RIC received samples and request forms from nurses, physicians, and medical assistants from various hospital wards. A total of 17,917 patients underwent 73,540 tests.

Results

The laboratories' total test procedure (TTP) had an overall error rate of 1.43%. It's interesting to note that pre-analytical errors made up the largest percentage (0.82%), followed by post-analytical (0.51%) and analytical (0.10%) errors. To determine the prevalence and scope of various errors, the data was carefully examined, and the findings were presented using figures and tables. The distribution pattern indicates that general mistake rates have significantly decreased during the last ten years. Even with this advancement, the pre- and post-analytical processes still had the highest rate of mistake.

Conclusion

The findings show that in order to improve patient safety and quality, it is necessary to create systematic protocols and keep ongoing vigilance to guarantee the correctness and dependability of the test processes performed in the laboratories.

Study of Gingivitis and Associated Factors among Adult Patients Visiting the School of Dentistry, Islamabad

Mishal Khan — 2025-12-19

Background: Gingivitis is one of the most common non-communicable diseases which affect people of all ages. Gingivitis is an inflammatory response of the oral cavity; if it remains untreated, it progresses into a severe disease named periodontitis. Clinical examination of gingivitis shows dental microbial plaque, redness, oedema, bleeding on probe, and halitosis. Our study aims to investigate the frequency of gingivitis by using the gingival index of LOE and SILNESS, and its association with clinical characteristics and oral hygiene visiting SOD, Islamabad. Methods: Prospectively, this is a cross-sectional study in which a non-probability/convenience sampling technique was used. Data from 100 patients who had a gingival index score from 0-3. A clinical examination was performed to measure the gingival indices of Loe and Sil ness of each participant, and clinical characteristics and oral hygiene habits were also noted. Chi-square analysis was used to find out the association between variables. Results: Our study analysis included 100 patients with an equal distribution of both genders, i.e. 50%. The mean age of the patients was 33.83± 10.71. Out of 100 patients, 10 patients had no inflammation (males n=4, females n=6), 34 had mild gingivitis (males n=17, females n=17), 35 had moderate gingivitis (males n=17, females n=18), and 21 had severe gingivitis (males n=12, females n=9). Our study results indicated a significant association of the gingival index with oral hygiene habits, i.e. Brushing (twice daily), mouth rinsing and smoking (p<0.005) and showed no association with oral hygiene habits, i.e. regular dental checkups and flossing (p>0.005). Similarly, our result analysis indicated a significant association between the gingival index and clinical characteristics, i.e. Gingival bleeding, dental plaque, toothache and bad breath(halitosis), with p<0.005, and showed no association with crowding (p>0.005). Our study results showed that, based on the Gingival index, the highest number of patients were seen to be suffering from moderate gingivitis, predominantly affecting female patients more, and the ratio of severe gingivitis was significantly higher in males. Conclusion: Our study concludes that gingivitis and its associated factors played a major role in poor oral health. With adherence to good hygiene practices, gingival health can be improved, and the risk of gingivitis can be minimized. Similarly, the development of severe gingivitis is also associated with the progression of worse clinical features.

Clinical Assessment of Skin Type, Acne Severity, and Psychosocial Burden: Implications for Pharmacist-Led Dermatologic Care in Pakistan

Marina Khan — 2025-12-19

Background: One of the most prevalent skin conditions among young people in Pakistan is acne vulgaris, which is influenced by genetic predisposition, hormonal activity, and skin type. Despite having a significant psychosocial impact, it is frequently overlooked in community settings. This study was designed to clinically assess skin type distribution, acne severity, and psychosocial burden among acne patients in Pakistan and explore the implications for pharmacist-led dermatologic care.

Methods: A community-based cross-sectional study involving 100 acne patients (ages 12–30) was conducted in Islamabad. Skin type, acne severity, and psychosocial distress were assessed using structured questionnaires and interviews. Chi-square tests were used to analyze associations.

Results: Oily skin was the most common skin type (69%). A significant association was found between skin type and acne severity (χ² = 18.36, p = 0.019). Severe acne was predominantly observed in oily (63.8%) and sensitive skin types (66.7%). Psychosocial burden was substantial, with 78% reporting embarrassment or reduced self-confidence.

Conclusion: Skin type significantly influences acne severity, with oily and sensitive skin types being at highest risk. High psychosocial distress highlights the need for pharmacist-led acne counseling, early screening, and community-based dermatologic interventions in Pakistan.

Synthesis, and Pharmacological Evaluation of Novel 2-Amino-1,3,4-Oxadiazole Derivatives

Sehran Saba — 2025-12-19

Oxadiazole is one of the vibrant heterocyclic nucleus and an important pharmacophore in the field of drug designing and discovery because of its diverse biological activities. The research conducted is focused on synthesis, biological activities and virtual screening of 2-(substituted phenyl)-1, 3, 4-oxadiazol-5-yl] benzamide derivatives. First 5-(substituted phenyl)-1, 3, 4- oxadiazol-2-amine was synthesized by reacting semicarbazide hydrochloride with 4- chlorobenzaldehyde and pyridine-3-carbaldehyde. These 2-amino-1, 3, 4-oxadiazole nuclei were further converted to corresponding amide derivatives by reaction with different benzoic acids in presence of dicyclohexyl carbodiimide (DCC) using acetonitrile as solvent. Newly synthesized derivatives were assessed for potential anti-inflammatory activity. Compound 1c was found to be most potent cyclooxygenase inhibitor with maximum mean paw volume displacement 0.233 (±) 0.012. Overall anti-inflammatory activity of all derivatives was found to be average as compared to standard drug. All eight newly synthesized compounds were docked against cyclooxygenase-2 (5F1A) to establish their binding potential. In-silico studies showed the interaction between newly synthesized compounds and cyclooxygenase-2 enzyme depending on both hydrophobic forces and conventional hydrogen bonds. Highest binding affinity was found to be -9.6 Kcal/mol by compound 1c which is greater than the binding affinity of standard molecule diclofenac sodium. These results suggested that 2-[substituted phenyl)-1, 3, 4-oxadiazol-5-yl] benzamide might be used as lead compound for further designing and manipulating new potential cyclooxygenase-2 inhibitors.

A Comparative Analysis of Complications of Intrathecal Dexmedetomidine versus Fentanyl as Adjuvants to Bupivacaine in Knee Joint Surgeries

Ishma Ahmed Malik — 2025-12-19

ABSTRACT

Background: The world is observing a rapid rise in orthopedic surgeries, and spinal anesthesia is usually the technique of choice for lower limb surgeries. Bupivacaine is generally the local anesthetic administered during these surgeries; however, adjuvants such as fentanyl and dexmedetomidine are also widely used to extend analgesia. The side effects and efficacy of such adjuvants, however, remain a topic of clinical interest. Objectives: To study the intraoperative and postoperative complications of two adjuvants, intrathecal fentanyl (25 µg), and dexmedetomidine (10 µg) for bupivacaine in patients undergoing knee joint surgeries and compare them. Materials and methods: A quantitative cross-sectional study was carried out on 80 patients, 40 in each group, recruited from PIMS Hospital and Allama Iqbal Teaching Hospital, Pakistan. All the patients were given spinal anesthesia, which included either intrathecal fentanyl or dexmedetomidine plus bupivacaine as an adjuvant. SPSS v22 was used for statistical analysis; one-way ANOVA was used to compare the complications, and statistical inference was drawn. Results: Dexmedetomidine caused prolonged sensory and motor blockade but, at the same time provided enhanced postoperative analgesia. It was also associated with a higher incidence of bradycardia and hypotension. Fentanyl increased the incidence of nausea and/or vomiting. Overall, once again, dexmedetomidine came out to be better of the two in terms of complications which were less in number and less severe, besides providing its usual strong analgesic effects. Conclusion: Intrathecal dexmedetomidine (10 µg) leads to better and longer analgesia with less complications, compared to fentanyl (25 µg), as an adjuvant to bupivacaine, hence providing a viable alternative for knee joint surgeries in terms of safety.

Message from Patron in Chief

Professor Dr. Mohammad Bashir — 2025-12-19

“Advancing Knowledge for Better Healthcare.”

It is a great pleasure for me to extend my support to the Journal of Bashir Institute of Health Sciences (JBIHS), Islamabad, especially as we celebrate this 10^th issue. In today’s world, where healthcare challenges are constantly evolving, promoting scientific research and academic publishing is not just an institutional goal, it is a responsibility we all share.

This journal reflects our commitment to fostering innovation, critical thinking, and ethical excellence. I am delighted to see young researchers, faculty members, and clinicians contributing to this platform with dedication and professionalism.

I encourage everyone in the health community, students, educators, and practitioners to engage with this journal, not only as readers but also as contributors. May JBIHS continue to grow as a source of knowledge, collaboration, and excellence in healthcare research.

I congratulate the Editorial Board for their hard work and extend my best wishes for the continued success of JBIHS.

Professor Dr. Mohammad Bashir, MBBS, DCP, MCPS, and FCPS

Patron-in-Chief
Journal of Bashir Institute of Health Sciences, Islamabad

Editorial

Professor Dr. Faryal Jahan — 2025-12-19

Editorial

“Advancing Knowledge for Better Healthcare”

The Journal of Bashir Institute of Health Sciences (JBIHS) continues its mission to promote evidence-based knowledge and foster scholarly discourse across medical and allied health sciences. In this issue, we present a diverse collection of articles that reflect the growing research capacity within our academic and clinical communities, addressing both local healthcare challenges and globally relevant scientific questions.

The research featured in this issue covers critical aspects of patient care, laboratory safety, oral health, dermatologic practice, pharmacological innovation, and perioperative management. Additionally, the review articles explore cutting-edge approaches in cancer therapy and provide insights into cardiovascular physiology and disease mechanisms. Collectively, these contributions highlight the importance of evidence-informed practice, innovation, and interdisciplinary collaboration in improving healthcare outcomes.

At JBIHS, we remain committed to publishing research that is methodologically sound, ethically responsible, and clinically meaningful. Each manuscript undergoes rigorous peer review to ensure academic integrity and reliability of findings. Our goal is not only to document scientific observations but also to encourage critical thinking, innovation, and collaboration among healthcare professionals, researchers, and students.

The advancement of healthcare depends on continuous inquiry and responsible dissemination of knowledge. JBIHS strives to serve as a bridge between academic institutions, clinical practice, and policy development, providing a platform for both established researchers and emerging scholars.

We extend our sincere appreciation to our reviewers and editorial board members for their dedication, and to our authors for entrusting us with their work. We encourage our readers to engage critically with the articles presented and to consider contributing to future editions. May this journal continue to inspire academic excellence and strengthen the culture of research within the health sciences.

Professor Dr. Faryal Jahan
Editor-in-Chief
Journal of Bashir Institute of Health Sciences, Islamabad Pakistan

A Review of Innovative Nanoparticle Based Approaches for the Treatment of Liver Cancer

Noaman Khan — 2025-12-19

Abstract:

Background: Hepatocellular carcinoma (HCC) is the most prevalent type of liver cancer with poor prognosis. Various drugs have been used to inhibit cancer cell proliferation, angiogenesis, and induce tumor cell apoptosis. However, drugs resistance, poor solubility, reduced bioavailability, restricted their clinical applications. Therefore, there is a need to develop novel therapeutic approaches based on nanoparticles (NPs) to enhance targeted drug delivery and improve therapeutic efficacy of HCC. Method: In this review, we retrieved already published data on nanoparticles-based vaccines, from PubMed, Google Scholar, Cochrane Library, and Science Direct. Results: These results indicate significant role of NPs based anti-cancer vaccines for the treatment of HCC or liver cancer. NPs based cancer vaccines compared to conventional liver cancer treatment showed lesser side effects, increased safety, minimum risk to normal body cells, reduced tumor growth, and enhanced delivery of anti-cancer drugs using NPs. Conclusion: Based on the literature, the study concluded that NPs based anti-cancer liver vaccines can provide better alternative to traditional liver cancer treatments like liver resection, liver transplantation, chemotherapy, and radiotherapy.

The Role of ACE2 in Blood Pressure and Hypertension: Insights from ACE2-Null Mice

Hammad Qaiser — 2025-12-19

Angiotensin-converting enzyme 2 (ACE2) is a transmembrane protein that plays a crucial role in fluid balance, the regulation of blood pressure, and lung function. Alteration in ACE2 enzyme by various factors, including genetic factors, hormones, cytokines, and environmental stimuli that lead to the onset of cardiovascular diseases, including heart failure, diabetic nephropathy, and atherosclerosis. It has a counter-regulatory function in developing comorbidities. Despite the extensive research conducted on ACE2, there is still a need for more specific research to address gaps in understanding. This review aims to explore the genetic factors and molecular mechanisms that regulate ACE2 and its role in the pathogenesis of hypertension and cardiovascular disorders. All the previous strategies that were used for preparing ACE2 null mice for research purposes are discussed in details. The inheritance pattern of hypertension associated with ACE2 is still unknown. In addition, the effect of overexpression of ACE2 effect brain-gut-lung communication in ACE2 null mice is not reported. Therefore, studies need to be done to fill these gaps and then to go for possible treatment. This review aims to address the existing research gaps and highlight the potential for future studies to enhance our understanding of ACE2. Ultimately, this knowledge could help to gain insight into the research gaps and to inform the development of new treatments for cardiovascular diseases, diabetic comorbidities, and related conditions.